call the sage-femme: notes from the life of a pregnant expat

You wouldn’t notice if you’re not looking for it.

It’s just a lively, sunny street like any other in Nice. A few blocks from the beach. There are busy cafés, antique shops, little kitschy stores full of ancient-looking sewing materials or dusty Lebanese groceries.

If you are looking, you’ll notice that this is a street full of pregnant women. You see them walking with friends or alone. You see them glamorous in sundresses and straw hats. You see them tired, clad in leggings and sneakers, struggling to transport all that weight. You might wonder where they are going.

blanket close up delicious diet
Photo by Scott Webb on

As I happen to be in the know, I can tell you. A well-known midwife practices on this street. She works at what some consider the best maternity hospital in Nice.

On my once- or twice-weekly visits, I buzz in, walk through a courtyard behind a heavy wooden door, and then take an elevator up several stories. The space is small, cozy, with a rooftop view that’s a little bit Parisian (save for the glimpses of palm trees). Colorful blankets are thrown on the low couches where I sit and listen to the midwife and take notes like my life depends on it.

Sage-femme. Literally wise woman. I am in awe of this woman: her knowledge, expertise, and manner. She holds hour-long classes about different aspects of birth–how to recognize labor, how to care for a newborn. As women (and sometimes their husbands) come and go, she scans cartes vitales (French healthcare covers these services), hooks women up to an electronic fetal monitor, answers the phone, and sets up new mothers with post-birth exercises in another room. Sometimes she returns holding someone’s tiny baby, and she’ll soothe it effortlessly, while discussing how to time contractions or while demonstrating breathing methods on an exercise ball. Though there’s so much happening, the midwife exudes calm. She doesn’t lose her train of thought. She never seems the slightest bit flustered. And though there’s some waiting involved–six of us on pause as she greets a new arrival or prints out the movements of a baby in utero–the environment is so generally agréable that personally, I don’t mind at all.

There are nine sessions covered by la Sécurité Sociale. Every time there are new girls–because these classes don’t have a set order–but every time I recognize a few. I haven’t spent any of my pregnancy with other pregnant women, and this has gotten lonely. No one to compare notes with. We live close enough to Nice to attend appointments there, but not close enough to spend real time there, the kind of time you need to actually make friends. I recognize this–loneliness–is a common expat struggle, and I’m grateful for the numerous blogs and books that discuss what it’s like to be alone in the land of your second language. Once the thrill wears off, it’s tough. The thrill wears off quickly.

So now, with all these pregnant women together in a room, I feel a little less alone. There are a lot of other foreigners–an assumption based on accent or the presence of a translating husband–and, obviously, a lot of prominent bellies. It is both a comfort and a fascination to look at all these people who look like me. This new me. No longer just woman or Millennial or brunette or American but the brand-new label: pregnant woman. It has taken some time to get used to that, to answer the questions I am inevitably asked in checkout lines at the grocery store.

Not only do all of us sport enormous third-trimester bellies–highlighted or camouflaged by various fashions–but I spy other swollen feet, others who have difficulty getting up from the low couches, and the telltale navy blue cotton band that characterizes most maternity jeans. As I’ve watched myself change in the mirror over the past several months, I have felt shock, occasional admiration, occasional horror. We change all the time, but rarely–I think–so quickly, so obviously.

I have grown used to many changes and I call that progress. The learning curve, though, can be so frustrating. Just when I think I’ve caught up, learned enough, mastered the French medical vocabulary, gotten good test results, or learned to balance all this new weight, there’s something new. Some new little worry, some new symptom, a new specialist to see just because (I suspect) my doctor is overcautious.

On my first visit to the midwife’s, I was nervous, not at all sure to what degree my personal space would be compromised. Now I enjoy the visits, trusting as I do that knowledge is power. While my doctor has no time, the midwife seems to have nothing but, despite juggling ten tasks (and a baby) at once. 

That first visit, the midwife puts the fetal monitor on my belly. I have a lifetime history of malaise around blood, needles, medical interventions, and even stressful-sounding beeping noises. It’s a proper phobia. I’m a fainter. The fetal monitor seems, somehow, to interest my baby, like it wants to show off for the attention. Previously that morning, I’d noticed nothing. As soon as I’m attached to this machine, wild movements start. The baby kicks around so furiously that my stomach–and by extension, the monitor–moves too. The numbers on the screen fluctuate rapidly and the sound of my baby’s heart is amplified, deafening. buhBOOMbuhBOOMbuhBOOMbuhBOOM. 

We hear something else, too, a little popping noise. The baby has the hiccups, the midwife tells me. I smile weakly. The concept is sweet. Amazing. Human. But what I’m looking at is my stomach, and here’s what I think, just before I almost lose consciousness. I think it’s something out of Looney Tunes. It looks like two small animals trapped in a bag, fighting to get out. A fist here. Pow. A kick there. Bam. 

I think: alien. Everything looks far away and I’m sweating like I’ve just come in from a run. My heart rate plummets. I am in the tunnel I’ve known since childhood, where I feel a misery and dread and pain that is typically only soothed by losing consciousness. My blood pressure, the midwife finds when she measures, has dropped to a ridiculously low level. My baby’s vitals have changed too. Then, somehow, I manage to come back. No fainting.

It means everything that the midwife doesn’t treat me like I’m weak or silly. She doesn’t express doubt or an attitude like–ha, good luck actually giving birth. She doesn’t laugh or say, wow, there’s a sensitive one. Instead she tells me something that surprises me: she too dealt with the same problem until her early twenties. Until after the first year of her midwifery studies. She says practice and gradual exposure was the solution. She says we’ll try this again, and again, until I’m okay with it.

At the next visit, I manage the monitoring with almost no discomfort. Ditto for the third. Each time I leave, I ask her a few more questions. Frankly I am most scared of giving birth in a country not known for customer service. I’ve heard stories of patients’ preferences being expressly disregarded. Google reviews of this very maternité say, in English and in French: that was the worst day of my life. I’m terrified of being forced into an outdated or unnecessary medical procedure. I am also very aware that I will likely lack the strength to both give birth and also fight the Man.

The midwife answers all my questions. She even alerts me when a French practice or standard tends to differ from the American one. This, to me, lends her a great deal of credibility. Still I feel the niggling worry of all these what-ifs.

She looks straight at me. She holds my face, says ça va bien se passer. It will be fine. She makes it possible to believe that this could be true.

3 thoughts on “call the sage-femme: notes from the life of a pregnant expat

  1. Daga

    I understand your situation, im like you foreigner in France . I just gave birth 3.5weeks ago and I can tell you this was one of the best expériences in my life. Basically french healthcare system is one of the best in Europe. During my labor all people comme sages-femmes were super kind to me. ( and it took me almost 30hours to finally give childbirth ). They will follow your wishes, just let them know earlier. I had epidural as much as I wanted (believe me, contractions are not easy to bear it and this level of pain you cannot compare with anything else). After labor,they looked after me and my baby very carefully and everything was covered by sécurité sociale and my mutuelle : )) Don’t worry, ça va bien se passer.


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